Study: 81 million opioid pills shipped to York County as U.S. epidemic grew

Lindsey O'Laughlin
York Dispatch

In the seven-year period from 2006 to the end of 2012, pharmacies in York County bought more than 81.4 million prescription pain pills from manufacturers and distributors, according to a database published by the Washington Post.

The total was enough to supply an average of 27 pills for every York County resident during each year covered in the data, the report stated.

And while that number might seem low compared to some of the other locations in the database — 179 pills per person in Logan County, West Virginia, and 146 pills per person in Pike County, Kentucky — York County Coroner Pam Gay said it doesn't tell the whole story.

"I think it would be most interesting to see the 2012 to 2015 data," she said, "because for York, those numbers (from 2006 through 2012) weren’t nearly as significant during that time period as they were for other parts of the country."

The number of pills in York County from 2006 through 2012 accounted for about 2.64% of Pennsylvania's 2.1 billion statewide total.

In Pennsylvania, Cambria County had the highest pill-to-person ratio with 61 pills per person per year and a total of 62.3 million pills overall.

Fayette County took a close second with 59 pills per person per year and a total of 58.3 million pills overall, followed by Cameron County (54 pills per person and 2 million overall) and Lackawanna County (53 pills per person and 79 million overall).

At the other end, Sullivan County had the lowest ratio, with 14 pills per person per year and 661,660 pills overall, followed by Fulton County (17 pills per person and 1.8 million overall) and Huntingdon County (19 pills per person and 6.4 million overall).

Among its neighbors, York County had the second-lowest pill-to-person ratio.

Adams County had 24 pills per person per year, compared with York's 27, and 17 million overall. Lancaster County was slightly higher, with 28 pills per person and 101.3 million overall. Dauphin County had 32 pills per person and 60.4 million overall, and Cumberland County had 34 pills per person and 55.5 million overall.

Court-ordered release: The Drug Enforcement Administration provided the data under a court order, and the Post analysis looked exclusively at distribution of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies, the Post reported.

This graph shows the five pharmacies with the greatest inventory of prescription opioid pills in York County from 2006 through 2012, according to data analyzed by The Washington Post.

In York County, Walgreens, Walmart and CVS pharmacies were in the top five for the number of oxycodone and hydrocodone pills received from manufacturers and distributors. A Walgreens store took the top spot, with 3.5 million pills.

The top manufacturer was SpecGx LLC, which had 43 million pills. Purdue Pharma LP, the company named in a lawsuit announced by state Attorney General Josh Shapiro back in May, took the fourth-highest spot, with 4 million pills.

The top distributor was Cardinal Health, with 16.8 million pills.

In a written statement, Purdue Pharma, the manufacturer of OxyContin, said today's opioid crisis is driven primarily by illegal drugs such as heroin and fentanyl, and that OxyContin accounts for less than 2% opioid medications prescribed in the United States.

"Opioid abuse is a subset of drug abuse in the United States, and the opioid addiction crisis is a complex societal problem that involves a number of different stakeholders, including manufacturers, prescribers, distributors, pharmacies, insurance companies, and governments at all levels," the company stated. "Attempts to pin blame on one party undermines the efforts of those tasked with understanding and addressing the crisis."

CVS also responded, saying that although it's primarily the prescribing doctor's responsibility to ensure opioid medications are being prescribed correctly, the company has taken steps that have resulted in a 30% reduction in the amount of controlled substances CVS keeps in its pharmacies.

"We maintain stringent policies, procedures and tools to help ensure that our pharmacists properly exercise their professional responsibility to evaluate controlled substance prescriptions before filling them," company spokesman Mike DeAngelis stated.

CVS has installed more than 2,200 safe drug disposal units in its stores and at police departments across the country, according to the statement.

The company also sponsors classes in which CVS pharmacists travel the country to speak with students and their parents about the dangers of prescription drug abuse and how to prevent it, among other initiatives, DeAndelis stated.

Attempts to reach the other manufacturers, distributors and pharmacies were unsuccessful.

In late 2017, York County filed a lawsuit against more than two dozen drug manufacturers, distributors and doctors for allegedly downplaying the risks of opioid medications and contributing to the current crisis.

Purdue Pharma and Cardinal Health are among those named in York County's lawsuit, along with Actavis Pharma Inc., now owned by Teva Pharmaceutical Industries, and McKesson Corp., all of which are named in the Post's database for York County.

York County consolidated its lawsuit with other Pennsylvania counties, and the suit is currently pending in Delaware County, said Michelle Pokrifka, solicitor for York County.

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Gay said the opioid crisis migrated eastward from the Midwest and that York County saw an increase in overdose deaths after 2012.

After 2015, she said, she expects the number of prescription opioid pills would be shown to decrease because of the increased pressure on physicians not to over-prescribe the drugs.

But that doesn't mean the death toll dropped.

"We’ve seen a steady decrease in prescription drug opioid deaths since 2014 at least, and an increase, or continual issue or problem, with illicit drugs," Gay said.

Most of the opioid deaths occurring now in York County are caused by heroin and fentanyl, she said, ingested both intravenously and through snorting.

As of Monday, July 22, there have been 54 confirmed opioid overdose deaths in York County this year, Gay said, and 50 of those were from heroin and fentanyl.

The remaining four deaths were caused by prescription pain medication.

Another 14 suspected opioid deaths from 2019 are still being investigated, she said.

Gay said overall opioid deaths in 2019 are on track to be about the same as the 2018 total in York County, which was 172 deaths, according to the York Opioid Collaborative. That total was slightly down from 2017.

Data showing the number of opioid deaths in York County caused specifically by prescription drugs during and after the time period shown in the database was not immediately available as of Tuesday.

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